Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Psychology, Harvard University, Cambridge, MA, USA.
Brain Behav Immun. 2024 Jul;119:211-219. doi: 10.1016/j.bbi.2024.03.036. Epub 2024 Mar 27.
Sexual minority individuals have a markedly elevated risk of depression compared to heterosexuals. We examined early threats to social safety and chronically elevated inflammation as mechanisms contributing to this disparity in depression symptoms, and compared the relative strength of the co-occurrence between chronic inflammation and depression symptoms for sexual minorities versus heterosexuals. To do so, we analyzed data from a prospective cohort of sexual minority and heterosexual young adults (n = 595), recruited from a nationally representative sample, that included assessments of early threats to social safety in the form of adverse childhood interpersonal events, three biomarkers of inflammation (i.e., CRP, IL-6, TNF-α) measured at two time points, and depression symptoms over four years. In pre-registered analyses, we found that sexual minorities experienced more adverse childhood interpersonal events, were more likely to display chronically elevated inflammation, and reported more severe depression symptoms than heterosexuals. Adverse childhood interpersonal events and chronically elevated inflammation explained approximately 23 % of the total effect of the association between sexual orientation and depression symptom severity. Further, there was an increased coupling of chronically elevated inflammation and depression symptoms among sexual minorities compared to heterosexuals. These results provide novel longitudinal, population-based evidence for the role of chronically elevated inflammation in linking threats to social safety during childhood with depression symptom severity in young adulthood, consistent with the primary tenets of the social signal transduction theory of depression. Our study extends this theory to the population level by finding that members of a stigmatized population (i.e., sexual minorities) experience a greater risk of depression because of their greater exposure to adverse childhood interpersonal events and the subsequent link to chronic inflammation, highlighting potential biopsychosocial intervention targets.
性少数群体患抑郁症的风险明显高于异性恋者。我们研究了早期社会安全威胁和慢性炎症升高作为导致这种抑郁症症状差异的机制，并比较了慢性炎症和性少数群体与异性恋者的抑郁症症状共发的相对强度。为此，我们分析了来自一个全国代表性样本的性少数群体和异性恋年轻成年人（n=595）的前瞻性队列研究的数据，其中包括以不良童年人际事件形式的早期社会安全威胁评估、两次测量的三种炎症生物标志物（即 CRP、IL-6、TNF-α）以及四年内的抑郁症状。在预先注册的分析中，我们发现性少数群体经历了更多的不良童年人际事件，更有可能表现出慢性炎症升高，并报告了比异性恋者更严重的抑郁症状。不良童年人际事件和慢性炎症升高解释了性取向和抑郁症状严重程度之间关联的总效应的大约 23%。此外，与异性恋者相比，性少数群体中慢性炎症升高和抑郁症状之间的耦合增加了。这些结果提供了新颖的纵向、基于人群的证据，证明慢性炎症升高在将童年时期的社会安全威胁与成年早期的抑郁症状严重程度联系起来方面发挥作用，这与抑郁症的社会信号转导理论的主要原则一致。我们的研究通过发现一个受污名化的群体（即性少数群体）由于更多地接触不良童年人际事件以及随后与慢性炎症的联系而面临更大的抑郁风险，将这一理论扩展到了人群层面，突出了潜在的生物心理社会干预目标。
